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Global Guidelines in Dermatology Mapping Project (GUIDEMAP): a systematic review of scabies clinical practice
Cherry Choudhary1,2, Victoria Cox3,4, Ryan Beazley5
1Chelsea and Westminster NHS Trust, London, UK.
Background:
Scabies is a neglected tropical disease endemic in many resource-limited settings worldwide.
Objectives:
Our objective was to assess individual clinical practice guidelines (CPGs) on scabies for their quality, accessibility, and applicability; with special attention to health equity implications.
Methods:
A literature search was undertaken to identify CPGs published on scabies, covering publications from 01/01/2010 to 30/08/2025. The search included a manual review of each dermatological society recognised by the International League of Dermatological Societies, guideline depositories and electronic databases. The CPGs which met inclusion criteria were critically appraised using the AGREE II Instrument, Lenzer's red flags and The Agency for Healthcare Research and Quality's National Guideline Clearinghouse Extent Adherence to Trustworthiness Standards (NEATS) instrument.
Results:
Fourteen CPGs met the inclusion criteria. There was significant heterogeneity in the focus area of the published guidelines. Each CPG had at least one low-quality domain on critical appraisal using the AGREE II instrument, and at least one red flag when applying Lenzer's methodology. Scoring was consistently low regarding 'Stakeholder involvement' on AGREE II and 'Patient and public perspectives' on NEATS and Lenzer's red flags. Only one CPG was published in a low SDI (Sociodemographic Index) country.
Conclusions:
Most CPGs published on scabies globally within the last 15 years had low methodological quality, with consistent lack of stakeholder involvement and were almost exclusively published in high SDI or upper-middle SDI countries. Expansion of research should be encouraged and supported in resource-limited settings which are currently underrepresented despite experiencing a higher burden of disease.
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